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Volum 01, Numarul 4, 1995

Cancer of the cervix: the pattern of care – Romania 1990-1991. The experience of7 radiotherapy

centres affiliated to SRRO

  1. Ghilezan1, Viorica Nagy1, R. Găleşanu2, V. Păcuraru3, V. Dimitriu4, Cornelia Togănel5, Valeria Mercea6, Laura Rebegea7

1Institutul Oncologic „Prof I. Chiricuţă” Cluj,

2Cl. Radiologicd I,

3Centrele Interjudetene Oradea,


5Tg. Mures

6Baia Mare,


The cervix cancer in Romania is of greatest gravity due to a high incidence and mortality which have doubled in the I-st decade. The objectives of the study undertaken by the SRRO were to establish the pattern of care for Romal1ia in 1990-1991, to identify the reason for this unacceptable situation and to suggest the solutions for the future. The main causes for this situation are: the advanced stages at presentation, a reduced accessibility to treatment, poor technical quality of the radiotherapy, inadequate policies of treatment and the lack of a permanent evaluation of the professional performances. These conditions are unchanged since 20 years and to improve the present situation, the Health Departlnent should become really involved by providing the funding for updating the technical conditions for the tretment and also by a continuos evaluation of the results.

Radioterapie & Oncologie Medicală, 1995. 4: 1- 8

The prognostic value of axillary lymph nodes histology (pN) after neoadjuvant therapy in locoregionally Advanced Breast Cancer (ABC)

Cristina Vitoc1, A. Rancea1,2, Angela Răşinarul, N. Todor1, N. Ghilezan1,2

1 Oncology Institute Cluj,

2UMF Cluj

Purpose: Prognostic of axillary lymph nodes (LN) after neoadjuvant therapy in locally advanced breast cancer. Methods and materials: 75 patients with locoregionally ABC, treated with neoadjuvant FEC orFEC + RT 50 Gy were submitted to surgery for the primai”y breast tumor and axilla. The following endpoints have been studied: local and distant control, no evidence of disease-survival (NED-8) and overall survival (0-8).

Results: The 5 years NED-S rates were 47%; 57% and 12%, and the 5 years O-S were 62%, 67% and 22% for pNo, 1-3 pN+ and ~ 4 pN+ respectively. Patients operated after neoadjuvant CT only had a more favorable prognosis than those operated after CT + R T, who despite similar local control had a much higher incidence of distant metastases (69% vs. 52%).

Conclusions: Pathologic examination of axillary lymph nodes in locoregionally ABC offers important information for sClcctulg optimal thcrapy for paticnts with favorablc tcsponsc to drugs, but not aftcr CT + RT for whom the risk of distant metastases is independent of pathologic status of axillary lymph nodes.

Key words: Locoregionally advanccd breast cancer, neoadjuvant chemotherapy, pathologic evaluation, axillary lymph nodes.

Radioterapie & Oncologie Medicală, 1995, 4:9-16

Clinical results in metastatic breast cancer and the emerging role of Taxol

  1. Fumoleau

Centre Rene Gauducheau, Nantes

Taxol is the first cytotoxic of a new class of drugs named taxanes which acts by stabilising the microtubules and so blocking the mitosis. Taxol, as single agent in first line for metastatic breast cancer gives 28 to 62% responses, in various regimens (135 – 250 mg/m2; 3 to 24 h infusion). The results as second line single agent are between 19 and 28% responses and for anthracycline resistant patients between 16 and 54% . All meta.”tatic sites, including visceral, are influenced favourably by taxol (39% RR for liver and 36% for lung metastases). The haema1:ological side effects are of lesser importance and with an adequate premedication, tile hypersensibility reactions are also very rare. In combination with anthracycIines, cis-platinum or cyclophosphamide, the response rates are 58-94%, 52-94% and 26-62% respectively. All these data highly recommend taxol for the treatlnent of metastatic breast cancer and to extend its indications for less advanced disease.

Kcy words: Taxol, breast cancer, taxol single agent, taxol combinations, taxol side cffects.

Radioterapie & OncologieMedicald, 1995, 4: 17-22

Taxol in the treatment of advanced loco-regionally breast cancer: preliminary results of a phase IIlI study at Oncological Institute Cluj

  1. Ghilezan1, Cristina Vitoc2, Georgeta Crişan3

1UMF Cluj-Disciplina Oncologie & Radioterapie,

2lnstitutul Oncologic Cluj-Radioterapie I.

3Spitalul Clinic Judeţean Tg, Mureş, Oncologie

Purpose: to confinn in a phase I/ll study, the efficacy oftaxol-single agent, in advanced breast cancer.

Methods and Materials: 150 mg/m2, 3 hrs infusion were given to a group of 10 patients with advanced breast cancer. End points criteria were: the clinical and histological response rate, side effect.

Results: after 4 cycles, 8 patients were operable (response rate 80%): there were 2TO, and 6 with residual tumours les than 3 cm; 5 from 8 patients had positive LN with 3 with 4N+. No major side effects were recorded.

Conclusions: the results confirm the efficacy of taxol-single agent in advanced breast cancer but the lack of significant side efects and the persistence of a heavily invaded axilla for patients with pretherapeutic N2, suggest the need for larger total doses (dose/cycle & number of cycles) or combinations to achieve better results in order to improve the survival.

Key words: taxol-single agent, advanced breast cancer.

Radioterapie & OncologieMedicală, 1995,4: 23-27

Split-course hypo fractionated radiotherapy is as effective as conventionally fractionated radiotherapy in the postoperative treatment of anaplastic oligodendroglioma. Preliminary results of a randomised trial.

  1. Glinski, P. Dymek, J. Skolyszewski

Department of Radiation Oncology of Maria Sklodowska-Curie Memorial Center, Krakow, Poland

Between 1986 and 1991, a prospective randomised study on 79 adults with cerebral anaplastic oligodendroglioma; was carried out. 37 patients underwent postoperative split-course hypofractionated radiotherapy (SCHR), and 42 patients received conventionally fractionated radiotherapy (CFR). In the SCHR group there were three courses of irradiation, separated with a one month interval. In each of the two first series, tIle patients received 20 Gy in 5 fractions in 5 days to the whole brain, and in the third series 20 Gy „boost” in 5 fractions in 5 days was delivered to the tumour bed. In the CFR group, the whole brain was irradiated to the total dose of 50 Gy in 25 fractions in 5 weeks, then a 10 „boost” in 5 fractions in 5 days was given to the site of primary lesion. The actuarial survival rates following SCHR and CFR were, respectively, 27% vs 24% at tv.-.o years, 25% vs 100/1) at three years, and 01)/1) in both groups at five years. The main prognostic factors are: Patient age, patient neurological status before

radiotherapy, and the extent of surgical resection.

Key words: anaplastic oligodendroglioma, radiotherapy, hypofractionation.

Radioterapie & Oncologie Medicală 1995, 4: 28-32

Chemotherapy delivery using port-a-cath systems for continuous infusions

Cristina Cebotaru, A. Rancea, T.E. Ciuleanu, D. Eniu, N. Ghilezan

InstitutulOncologic „Prof. I.Chiricuţă” Cluj-Napoca

The demonstration of an improved efficacy for the protracted infusions of phase-specific citostatic drugs has stimulated the development of the infusion delivery technologies, with an incresing use of the port-a-cath and automatic delivery pump systems. Authors experience in the Radiotherapy department of the Oncological Institute „Ion Chiricuţă” of Cluj, dealing with the use of these modem devices for chemotherapy delivery is presented. The main advantages are represented by an improved efficacy and a better quality of life.

Keywords: port-a-cath, chemotherapy, protracted infusions

Radioterapie & Oncologie Medicală, 1995. 4: 33-38

The state of the art of radiotherapy in the treatment of esophageal cancer

Roberto Orecchia1,2, Carlo Greco2, Giovanna M. Gatti2

1 Chair of Radiotherapy, University of Milan

2 European Institute o.f Oncology – Milan Italy

Esophageal carcinoma is a disease with a poor prognosis. Surgery has always been considered the therapy of choice for this kind of neoplasm, With unsatisfactory results in terms of survival and quality of life (in case of lesions arising in the cervical region it is necessaty to combine esophagectomy and phatyngolaringectomy). Our intent is to discuss the role of radiotherapy in a multimodal therapeutic approach, which could allow an increase in local control of the disease, while reducing the incidence of distant metastases is still a matter of open discussion. We will give a review on the three major roles of radio therapy in esophageal cancer, which are radical radiotherapy, preoperativc radiotherapy and postoperativc radiotherapy, and on future trends in the same field.

Radioterapie & Oncologie Medicală, 1995, 4: 39-46

Implications of human viruses in carcinogenesis

Jean Bourhis

Institut Gustave Roussy (Radiotherapie et Pharmacologie Moleculaire)

Only a limited number of human virus have been shown to have oncogenic properties, including the retrovirus HTL VI and 2, the B hepatitis virus (HBV), fue Epstein-Barr virus (EBV), and some human papillomas virus (HPV). Epidcmiologic and molccular biological studics havc shown fuat fucsc virus wcrc involv,cd as cofactors in the multistep process of carcinogenesis. Viral DNA probes or antibodies against vira! proteins can prove to be useful tools for diagnostic (HTL VI, EBV, HBV) or prognostic (HPV) of some cancers. A better knowledge of fuese viruses may also have fuerapeutic implications in a not too distant future such as fue vaccination against HBV in order minimize fue incidence of hepatocellular carcinoma in endemic countries.

Radioterapie & On cologie Medicală, 1995, 4: 57-61

62 Annual Conference of SRRO

67 ETHYOL: Current and Future Applications in Cytoprotection Monte Carlo, 28 september – 1 October 1995